Nokea
A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors?
- A. Diphenhydramine
- B. Flunisolide
- C. Beclomethasone dipropionate
- D. Pseudoephedrine hydrochloride
Correct Answer: A
Rationale: Diphenhydramine is an antihistamine used for allergic reactions. Flunisolide is a nasal decongestant agent and is used locally to the nasal mucosa. Beclomethasone dipropionate is a nasal steroid spray and inhalant. Pseudoephedrine hydrochloride only constricts nasal membranes.
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A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?
- A. To decrease the body's risk of infection
- B. Because an autoimmune disease is a neoplastic disease.
- C. So the client has strong drug therapy
- D. For their immunosuppressant effects
Correct Answer: D
Rationale: Drug therapy using anti-inflammatory and immunosuppressive agents is the mainstay for alleviating symptoms. Some antineoplastic (cancer) drugs also are used for their immunosuppressant effects. Antineoplastic drugs do not decrease the body's risk of infection; an autoimmune disease is not a neoplastic disease. Drugs are not prescribed just so the client has strong drug therapy.
A client has an allergic reaction to seafood with generalized edema and reports being unable to get a wedding ring off as it is too tight. The client was unable to remove it with soap and water. What action by the nurse can facilitate removal of the ring without damaging it?
- A. Administer a diuretic and wait for the swelling to go down.
- B. There is not another option other than to use a ring cutter to remove the ring.
- C. Use twine to wrap the finger and, when the tissue is compressed, pull the free end of the twine and remove the ring.
- D. Use a tongue blade to remove the ring.
Correct Answer: C
Rationale: If applying soap or oil to the finger proves unsuccessful, the nurse may wrap the finger with twine. Once the tissue is compressed, the ring can be removed by pulling on the free end of the twine. This technique is preferable to damaging the ring with a metal cutter. If nothing else facilitates ring removal, however, cutting the ring is a better option than allowing damage from ischemia to develop. The nurse cannot administer a diuretic without a physician's prescription, and allowing the swelling to go down may cause tissue ischemia from the constricted ring. There are options other than cutting the ring, but if they fail, there is no other choice. A tongue blade will not remove a ring that is too tight.
The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?
- A. Progressive tissue damage without any verifiable etiology
- B. Absence of a triggering event
- C. Profound fatigue with no identifiable cause
- D. Affects only older adults and infants less than 3 months
Correct Answer: A
Rationale: Diseases are considered autoimmune disorders and are characterized by unrelenting, progressive tissue damage without any verifiable etiology. In many autoimmune disorders, there tends to be a triggering event, such as an infection, trauma, or introduction of a drug that integrates itself into the membranes of the host's cells. Although older adults face a greater risk of developing autoimmune disorders, persons belonging to any age-group can be affected. Chronic fatigue syndrome is primarily characterized by profound fatigue with no identifiable cause, and this is not a characteristic of autoimmune disorders.
A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring?
- A. Delayed hypersensitivity response
- B. Anaphylactic reaction
- C. Sensitization
- D. An immediate hypersensitivity response
Correct Answer: A
Rationale: A delayed hypersensitivity response may develop over several hours or days, or it may reach maximum severity after repeated exposure. Examples of a delayed hypersensitivity response include a blood transfusion reaction that occurs days to weeks after blood administration, rejection of transplanted tissues, and reaction to a tuberculin skin test. Anaphylaxis is a rapid and profound type I hypersensitivity response. Sensitization is the process by which cellular and chemical events occur after a second or subsequent exposure to an allergen. An immediate hypersensitivity response is due to antibodies interacting with allergens and occurs rapidly.
A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?
- A. A disorder where the body has too many immunoglobulins.
- B. A disorder where histocompatible cells attack the immunoglobulins.
- C. A disorder where killer T cells and autoantibodies attack or destroy natural cells - those cells that are 'self.'
- D. A disorder where the body does not have enough immunoglobulins.
Correct Answer: C
Rationale: Autoimmune disorders are those in which killer T cells and autoantibodies attack or destroy natural cells-those cells that are 'self.' Autoantibodies, antibodies against self-antigens, are immunoglobulins. They target histocompatible cells, cells whose antigens match the person's own genetic code. Autoimmune disorders are not caused by too many or too few immunoglobulins, and histocompatible cells do not attack immunoglobulins in an autoimmune disorder.